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Intro And Help With Cymbalta Roadmap


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#1 coffeetennis

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Posted 06 July 2022 - 10:50 AM

Hi all, I'm looking for a bit of guidance as I navigate a tricky situation. I've been on Cymbalta 20mg for just under 3 weeks. I'm taking it for anxiety and discomfort (likely neuromuscular) related to pelvic floor issues. Along with a few other things I'm doing, the Cymbalta has helped calm anxiety about my situation and lessened discomfort so I can get some sleep at night. Main side effects: noticeably low libido and sleep disturbances (different from my usual sleep symptoms).

 

Here's where things are tricky: I'm scared of these meds. I spent 10 years on Effexor, Cymbalta's cousin, and had a hell of a time going off it and avoiding withdrawal-related PSSD. Long story short, I got PSSD every time I tried to come off Effexor until the last time. Now I'm on Cymbalta due to this neuromuscular pelvic condition and I'm scared of getting PSSD when coming off. Or at least that the libido issues I'm currently having won't resolve.

 

The problem? Cymbalta is working (minus the sleep disruptions), and I may need help keeping anxiety at bay so that some specialized pelvic treatments I need will actually work. Basically, anxiety makes it hard to treat this condition and I want to get better ASAP.

 

What I'm hoping you can help with: any guidance on how hard it will be to come off Cymbalta after, say 3-4 months. In one scenario, I stay on them long enough to make significant progress with physical therapy and start tapering off them. Also, how hard is it to avoid PSSD when tapering off these meds? When I took Effexor, my libido and sexual functioning were perfectly fine (except for delayed orgasm). It was only upon *stopping* the Effexor that numbness, low libido, and premature ejaculation happened. I'm scared the same will happen on Cymbalta.

 

Sorry for the long post, and I'm not looking for medical advice or anything. Just a sense of what coming off these meds might look like and whether I should just get off them now. I'm all too aware that I'm playing with fire here.


#2 invalidusername

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Posted 06 July 2022 - 12:56 PM

Hi there, and welcome to the forum...

 

You have been well received by the Cymbalta if you have noticed positive improvements within 3 weeks. Not altogether unheard of, but it usually takes a little longer.

 

Libido issues are quite common with these drugs and I can understand your concern. I have been on Citalopam (Celexa) for almost 15 years and I am having a nightmare of a time coming off them. It is natural to feel this way about the symptoms that they can induce. 

 

I want to address what you said... "I want to get better ASAP". This gives the impression that you are wanting things to move as fast as possible, but these things take as long as they take. In getting yourself worked up about the time taken will only inhibit the length of them working, or you, yourself, getting to a place whereby you can function more "normally". You need to understand that an anti-depressant is there to MASK an underlying problem. Once removed, the issue may still be there. You may have gotten used to your situations from the support the AD gives you, in which case, this can be the cure. But you need to understand that these pills artificially produce more chemicals in the brain to aid your condition. Once removed, the brain has to do this on its own. 

 

This is why so many people find that they cannot remove themselves - myself included.

 

There is no way of saying how difficult it will be to remove yourself from these drugs after x number of months. It is simply not possible - and don't believe anyone who tells you otherwise. The way that these drugs interact with your brain is subjective. No-one knows, not even doctors, what will occur once you have started down this path. You need to weigh up the potentials. If you feel as though the Cymbalta will help you in your current state, then it is worth maintaining the dose until you feel in a position to slowly withdraw...

 

Speaking of which, this will be the answer to your previous concern. Time and patience is that which is really required when coming off these drugs so that your neurochemicals have the time to appropriately balance out.

 

IUN


#3 fishinghat

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Posted 06 July 2022 - 04:29 PM

Welcome Coffeetennis

 

I developed PSSD when I came off of Cymbalta as well as a total failure of testosterone production. Your concerns are justified. I have spent many many hours reading everything I can about PSSD. Our ebook has a good section concerning current research however at this time there is little information on treating it if it does develop. I can tell you that in general the slower you wean off the better the odds of minimizing this aftereffect. While in my case it has become permanent most members who develop this condition do improve within 3 months after the last dose. My case is a little unusual as my libido never dropped any at all. I still have a high libido but absolutely no physical response to any physical or psychological sexual stimuli. A very tough thing to deal with.

 

Again, my recommendation would be a very slow withdrawal once you decide to come off. I would recommend at least a 1 yeaar withdrawal.


#4 coffeetennis

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Posted 08 July 2022 - 08:56 AM

Thanks very much for your thoughts, guys. I've decided to taper off the Cymbalta now, while I've only been on it a short while. I know any antidepressants can cause withdrawal issues, but I've historically had so much more trouble with these ones with beads. No idea why.

 

IUN, I came across this post from last year where you recommended a 10% taper every 2 days for someone who'd been on Cymbalta about as long as me. This makes sense to me and I tried it last night. However, the stupid litle capsules are so small and tight that I couldn't open them without damaging them. I got some empty gel capsules and transferred the beads there.

 

In theory, this should work. However, I felt that the meds hit me differently when coming from the new gel capsules. (Take my word for it; it doesn't feel like withdrawal.) Do you guys have any tips on how to open these little capsules?


#5 fishinghat

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Posted 08 July 2022 - 12:47 PM

I never had any problems opening my capsules but I kno0w some members did. Youi might try warming then a little (hold them in your hand a couple minutes) bit. That should help soften them so they are not crushed so easy when trying to open them. Let us know how that works out.


#6 fishinghat

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Posted 08 July 2022 - 12:54 PM

Just some notes from our free ebook.
 
Opening Capsules
 
FH - I have never heard of the cold trick but at reduced temperatures most materials will crack easier. The gelatin used in most capsules is designed to dissolve around 89F so I would think that warming them in your hand for a few seconds would soften the capsule and make it easier to open without damaging it.
 
Overwhelmed - When I took the 4 capsules apart to count & divide for my bead estimate, I had the same problem. After pulling & twisting, I ended up mutilating the capsules, I had to cut the ends off to get the beads out. That time, I had put them in them in the fridge first, I had read somewhere that it helps with the static electricity when counting. Thinking that was the cause of not being able to get them apart, I then left them out for this past week & thought the problem was solved. Just as a test, I opened one of my left-over 60mg capsules, they came apart & went back together very easily. 
 
KFL -Someone told me that they put their beads in the freezer and that stopped static cling, but do that after opening the capsules and putting the beads in a different container. I found that the capsules were difficult to open if they had been stored in the freezer.

#7 coffeetennis

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Posted 08 July 2022 - 04:31 PM

Thank you! I'll play around with these methods. My suspicion is that the smallest capsules are harder to open...I'll report back if/when I find a method that works!


#8 coffeetennis

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Posted 08 July 2022 - 06:00 PM

Quick update: I got the 20mg capsule open! I warmed it in my hand for a few minutes, until the blue top wanted to turn a bit. Then I twisted the top while gently pulling up a bit. Eventually, it came off and I removed the requisite beads.

 

This was a bit painstaking but straightforward. I've been feeling "off" all day today after taking the beads in a new capsule, but I'll continue my taper tonight with the beads in the proper capsule. Hoping for the best.


#9 fishinghat

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Posted 09 July 2022 - 07:53 AM

Thats great, thanks for the info.


#10 coffeetennis

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Posted 09 July 2022 - 07:58 PM

Unfortunately, I've ruined a few capsules tonight trying to take them apart. And putting the beads into a new empty capsule just doesn't work for my body (for whatever reason). I'm just going to have to start skipping days or adding hours between doses. This is discouraging, but I have to hope that just over 3 weeks on these meds means I won't have withdrawal or PSSD symptoms. Who knows.


#11 fishinghat

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Posted 10 July 2022 - 07:35 AM

Skipping days is not a good idea according to the FDA. By the time your next capsule is due your blood levels are down 94% (approximately) and then they raise back up sharply with the next dose. This causes your body to repeat its withdrawal over and over. 

 

One thing you might consider is to talk to your pharmacist about getting Cymbalta from a different source. Maybe that will be a lot easier to work with.

 

A way to solve your problem is to contact a local compounding pharmacy. Compounding pharmacies can make up different doses ahead of time. Many will make Cymbalta capsules with a specific dosage inside the capsule. Some can make a liquid Cymbalta which is easily dose adjusted by slightly reducing your dose with time. Be aware that sometimes these compounding pharmacies can be very expensive. I have seen members quote prices of $100 to $1200 per month. The good news is that there is no cost to call the pharmacy and check on what they can do and how much it will cost. Also, insurance sometimes covers compounding costs and some don't so you need to talk to them as well.


#12 invalidusername

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Posted 20 July 2022 - 03:25 PM

How are you doing coffeetennis?

 

Hat was absolutely right about being careful about missing doses. This is all to do with the half life of Cymbalta. It will not end up well.

 

Much like Hat, I have never had a problem with opening up the capsules. At the worst case scenario, you can take a serrated kitchen knife to the capsules and just slice them open. A number of people have stated problems opening by hand. Whilst I have not had this problem, that is not to say that it doesn't exist! It is like a jar of peanut butter or jelly!!! LOL.

 

But whatever you you do. ensure that you keep on a daily schedule, It will do you will. 

 

If you need any further help, just let us know. We are always here for you regardless. Even we have issues. I am in the middle of a mild crisis as a result of a VERY mentally ill wife. I am as good as holding down a full-time job (being in my mid-40's) as well as looking after the wife at the drop of a hat when she needs me. Whenever I am out for work... she texts me... I need to stop whatever I am doing and be there. It can be a tough life, I know what you are going through...

 

IUN





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